Understanding Dementia and Alzheimers as a Caregiver

Dementia and Alzheimers are some of the more common ailments you may see in the elderly.  As a caregiver it is important to understand these diseases and proactively treat your patient.

As a Caregiver what are the most important things to understand about the patient with Dementia or Alzheimers that will help you promote good care?

Understand where the individual is within the memory-loss spectrum.  You can then compensate for the deficiencies in their memory and enhance your communication within the memories they have. Compensation can be as simple as offering choices in things like meals, instead of forcing the person to recall which meals mean what foods and when meals are offered. By giving choices, the person can be successful in selecting from immediate information and you can ensure that the person is eating as they should for their overall health. Some individuals with memory loss may forget to eat or think they haven’t eaten and eat again. Either way, this is harmful to their health. So, offer choices. It makes a person feel more in control of their world.

Another important point is to understand where your person is within a timeline. Most of us feel that it is better to correct the person in the hopes they will remember. Their memory loss is not something they control, and not something that improves in these conditions. To help the individual feel more successful and therefore more secure in their world, go to the time in which they live, and relate to things from that perspective. If the individual has given you information that leads you to the year when the caregiver was a child of 6, go there and remember what your life was like and respond to questions as though still in that era and the person will feel confident to communicate openly. If not, they will avoid communication because they can’t follow you. An important issue to remember with this aspect of care is, do not tell the person about a loved one’s death. If they didn’t remember in the first place, you’re reminding them over and over again and it becomes a source of never-ending grief.

 

Safety always seems to be the number one concern with any patient, what are some safety measures you take with patients suffering from alzheimers or dementia?

Safety is a huge issue for everyone. Obvious preparations are things like grab bars in bathrooms, securing loose rugs, and installing electric in place of gas in a kitchen.  Less obvious safety measures can be a cordless phone that can travel around the home with the person (in some cases in an attached bag on their walker), making sure a deadbolt lock does not have a key on both sides of the door, and putting stickers on the floor of the bathtub. Tub stickers are not just for the prevention of slipping but also for seeing where the bottom of the tub is when getting in. Then there is color: Nothing is harder for someone with compromised vision than a room (think of bathrooms and kitchens here) all in one color.

What effects do you see Alzheimers and dementia have on the patient and family?

We have seen Alzheimer’s and dementia having a significant impact on the relationship of family members to the victim of the condition. It affects everything from occasional holidays like Thanksgiving to day-to-day communications. Think of yourself in a country where English isn’t spoken and you don’t speak the language. Everything from getting something to eat to finding directions would be impacted. Now consider this when you think of someone with these conditions. Depending upon the severity, life as they knew it would be lost.

What are some tactics you have used to help lessen this impact? 

We recommend that families find a common ground for communicating, and this is not wholly unlike communicating with someone of another language. What do you and the individual both know?  We suggest families put an album together of old pictures, and sit together with your loved one and use them as a point of common ground. Use memories in general as a point of reference and enjoy living these old memories. Remember to keep them positive: you don’t want to bring up how you and your brother stopped talking or why your sister’s in rehab. These memories bring no one any joy, and joy is what you’re aiming for.

 

Could you make us a small check list of things to make sure you do to make a patient safer, more comfortable, and possibly improve their treatments?

Safety is one issue and can be pretty generalized. Comfort and improved treatment are really individual issues.  Like beauty, they are in the eyes of the beholder. It comes down to what a person considers comfort, and what their wishes are regarding treatment. I’ve mentioned a few general safety tips in the above responses.

Is there anything additionally that you think we should add to the caregivers arsenal of knowledge to improve our patients lifestyle or treatment? 

Two things: Be it substitute caregivers (professional) or facilities, do your homework and remember – one size does not fit all and reputation is a critical factor. Explore, research and interview. Aim high. Second, remember that the person was, not all that long ago, a fully functional individual, and for many they still feel they are. Respect, empowerment and individuality are keys to improving a lifestyle for anyone, even ourselves. Treat the person the way you would hope someday to be treated. For many of us, we are creating the model for our children’s future.  The saddest cases I think we work with are cases where this basic principle was never considered.

Patricia Maisano is an expert on eldercare and finding the best situation to optimize the quality of life of seniors on a case-by-case basis.  Patricia is a Registered Nurse (RN), Certified Case Manager (CCM), Fellow in American Academy of Case Management (FAACM), Professional Geriatric Care Manager (PGCM), Registered Guardian (RG) and certified member-American Board of Disability Analysts (ABDA).   She is the CEO of Ikor USA which is a growing network of healthcare advocate and guardianship offices that specialize in caring for elderly and disabled individuals.